Documentation:
Unlock Payment for Unlisted Procedures With Pre-Authorization
Published on Wed Apr 06, 2011
Start documenting before the procedure to help win the bottom line battle. Selecting the correct anesthesia code for a surgical procedure can be tricky enough some days when you're coding for a well-defined surgery. Start tackling procedures that don't align with an anesthesia code, however, and you're dealing with one of the biggest coding challenges: obtaining appropriate payment for unlisted procedures. Roadblock: The medical policies for many payers include disclaimers that every benefit plan defines which services are covered and which are excluded. The next time your physician provides a service that doesn't fall neatly under a CPT code and you resort to "unlisted," keep these tips in mind to bolster your chances at reimbursement. Connect With a CPT Code "Find a way to relate the procedure to an existing CPT code as support for reimbursement. Also explain, however, how your physician's procedure differs to show why you didn't choose [...]